This study aimed to characterize the best predictors for unmet dental treatment needs and patterns of dental service utilization by adolescents in the Kingdom of Lesotho, Southern Africa. A self-reported 40-item oral health survey was administered, and clinical oral examinations were conducted in public schools in Maseru from August 10 to August 25, 2016. Associations between psychosocial factors with oral health status and dental service utilization were evaluated using simple, bivariate, and multivariate regressions. Five hundred and twenty-six survey responses and examinations were gathered. The mean age of student participants was 16.4 years of age, with a range between 12 and 19 years of age. More than two thirds (68%; n = 355) of participants were female. The majority reported their quality of life (84%) and general health to be good/excellent (81%). While 95% reported that oral health was very important, only 11% reported their personal dental health as excellent. Three percent reported having a regular family dentist, with the majority (85%) receiving dental care in a hospital or medical clinic setting; only 14% had seen a dental professional within the previous two years. The majority of participants did not have dental insurance (78%). Clinical examination revealed tooth decay on 30% of mandibular and maxillary molars; 65% had some form of gingivitis. In multivariate analysis, not having dental education and access to a regular dentist were the strongest predictors of not visiting a dentist within the last year. Our results suggest that access to oral health care is limited in Lesotho. Further patient oral health education and regular dental care may make an impact on this population.
Keywords: Lesotho; access to care; adolescents; barriers to care; caries; dental needs; oral health; unmet needs.